Neonatal opioid withdrawal syndrome

Obstet Gynecol Clin North Am. 2014 Jun;41(2):317-34. doi: 10.1016/j.ogc.2014.02.010.

Abstract

Neonatal opioid withdrawal syndrome is common due to the current opioid addiction epidemic. Infants born to women covertly abusing prescription opioids may not be identified as at risk until withdrawal signs present. Buprenorphine is a newer treatment for maternal opioid addiction and appears to result in a milder withdrawal syndrome than methadone. Initial treatment is with nonpharmacological measures including decreasing stimuli, however pharmacological treatment is commonly required. Opioid monotherapy is preferred, with phenobarbital or clonidine uncommonly needed as adjunctive therapy. Rooming-in and breastfeeding may decease the severity of withdrawal. Limited evidence is available regarding long-term effects of perinatal opioid exposure.

Keywords: Buprenorphine; Methadone; Neonatal abstinence syndrome; Neonatal opioid withdrawal; Perinatal substance abuse.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use*
  • Breast Feeding
  • Buprenorphine / therapeutic use*
  • Female
  • Humans
  • Infant, Newborn
  • Male
  • Methadone / therapeutic use*
  • Neonatal Abstinence Syndrome / drug therapy
  • Neonatal Abstinence Syndrome / epidemiology*
  • Opiate Substitution Treatment*
  • Pregnancy
  • Pregnancy Complications
  • Pregnancy Outcome
  • Risk Factors
  • Substance-Related Disorders / drug therapy
  • Substance-Related Disorders / prevention & control*
  • United States

Substances

  • Analgesics, Opioid
  • Buprenorphine
  • Methadone